Informed Consent, Competence, and Multiple Relationships
Core concepts
Informed consent requires that the client receive and understand the nature and purpose of services, fees, confidentiality limits, risks and benefits, alternatives, and the right to withdraw. Consent must be voluntary and, for research, documented. Competence means practicing within the boundaries of education, training, supervised experience, and consultation; when working with populations or techniques outside one's competence, obtain training, consultation, or supervision, or refer. Multiple relationships exist when a psychologist is in another role with a client or someone closely associated with the client, or promises to enter one. Not all are unethical; they become problematic when they could impair objectivity or risk exploitation or harm.
Traps
Questions often present a consent form as sufficient - consent is an ongoing process, not a signature. Another trap is assuming any dual relationship is prohibited; the standard is risk of harm and impairment, not mere existence. Watch for competence traps involving emerging areas, cultural competence, and assessment with unfamiliar populations. Also note that consent for minors involves both assent and guardian permission, with attention to the minor's developmental capacity.
Rule of thumb
For multiple relationships, ask whether the added role could impair the psychologist's judgment, exploit the client, or harm the therapeutic relationship. If yes, avoid it; if unavoidable, document safeguards and consultation.
Worked example
A therapist is asked to treat a neighbor. The relationship is not automatically prohibited, but the risk of impaired objectivity and future role conflicts is high; the therapist should consider referral and, if proceeding, discuss the risks with the client and document the decision.